Ms Gauci said that manic depression is very hard to diagnose because the majority of sufferers only go to their doctors when in the depressive phase, which commonly leads to a mistaken diagnosis and treatment for unipolar depression (clinical depression).

This makes life even harder for those who suffer from the disorder because manic depression is in itself an upheaval for the person every time they go through a cycle. This information briefing was held to coincide with the launch of a Patients’ Charter

yesterday.

The effects of the manic and depressive cycle

The major problem with bipolar disorder is that when in the manic phase, the patient will not accept that there is anything wrong with him or her. That person will feel like they are on top of the world and that nothing can hurt them. These manic phases also bring about periods of extreme industriousness where the person can stick to a task for hours if not days on end.

Sufferers will also display a marked flair for creativity during the periods of mania. If this is compounded by a misdiagnosis of clinical depression, doctors may describe ‘upper’ drugs, which aim to beat depressed feelings. Coupled with the effects of mania, these drugs will boost the sufferer even higher, which will in turn increase the effect of them crashing back into a depressive cycle.

In addition to the depressive cycle, which is more or less self-explanatory, there is also what is known as a mixed episode – that is both manic and depressive symptoms being present every day for about at least a week.

A hypomanic episode is less serious than a manic phase; these episodes are milder and delusions and hallucinations do not arise.

The development of the illness is hard to predict as no two people are alike and the lengths of the respective phases are not the same with all sufferers. Rodney Elgie, chairman of the Gamian Group also addressed the meeting. The Gamian Group is a pan-European federation of national patient organisations from all over Europe covering the whole spectrum of psychiatry. The Gamian Group recently conducted a survey – BEAM – that was aimed at finding out more of the plight of manic depression sufferers. Dr Elgie said: “It is a very difficult illness to pinpoint, but once it is diagnosed help is at hand. What people must realise is that it is an illness that will be with them for life, but it can be controlled,” he said.

Dr Elgie warned of the danger of confusing bipolar disorder with clinical depression. He said that the findings of the study conducted by Gamian established that 55 per cent of sufferers went to their doctor in the depressive state. He said it was perhaps the most common – yet least known about – mental illness. We need an effective partnership between all those concerned, he said. He also explained the variation of the illness between rapid cycle manic depression and a more elongated (both manic and depressive) cycle.

Dr Elgie said that not much was known about the cause of manic depression, but it seems to stem from bio-chemical imbalances, stress and tension as well as being genetic. “There is a lot we have yet to learn,” he said.

Recognising the symptoms

Ms Gauci and parliamentary secretary Helen D’Amato both said that there were two essential needs to help people with

bipolar disorder.

The first is that doctors and potential sufferers (anyone) must read up and be informed about the illness. The commonest mistake is that patients do not realise that mania is precisely that – mania. They think it is their normal self. Ms Gauci explained that sufferers only think there is something wrong when they are in a depressed state. “They only tell their doctors that they feel depressed. When they are in mania, even something as extravagant as buying a Ferrari or 35 pairs of shoes seems to them as being utterly normal. When suffers are in mania, it is very difficult for them to accept that they are not in a normal state,” she said.

Another very important aspect, particularly touched upon by Ms D’Amato, was that everyone had to work hard, particularly the media, to erase the stigma that surrounds mental illness.

“The stigma attached to any mental illness is the most detrimental thing of all. At least with the Richmond Foundation’s Patient Charter, sufferers might at least feel more empowered. And another positive is that the charter bridges the language gap as it is available in both English and Maltese,” she said.

Ms D’Amato said the patient had to be the focus of everything. “We must give these people the help and the support they need to get out of what can be a very unhappy and dark period in their life,” she said.

Mrs Gauci said that bipolar disorder was a lot more common than people thought. “There are about 8,000 sufferers in Malta alone (two per cent of the total population),” she said.

Effects on the family

The Patient Charter booklet also highlights the effects of bipolar disorder on the sufferers’ family and friends. The booklet states that when a patient is in a depressed state, family and friends feel frustrated, angry and guilty because they cannot help the sufferer or even at least understand why they are behaving the way they are.

The Richmond Foundation believes that families should be taught how to be of consolation and of support to victims of the illness without allowing it to become a burden on the whole family.

Treatment

There are various forms of treatment, from medicinal to therapy and group therapy self-care groups. Medicines include mood stabilising pills, which not only control the manic phases, but also help control mood change.

There are also anti-psychotic drugs that are used in short bursts to control periods

of mania. Traditional anti-

depressants are used to control depressive periods but it is not recommended that they are used on their own.

Yesterday’s event was sponsored by GlaxoSmithKline, one of the companies that produces drugs to fight manic depression. One of the drugs has also been found to be effective in treating epilepsy.

For more information on

bipolar disorder or other

mental health problems one

can visit the Richmond Foundation website on www.richmond.org.mt or send an email to [email protected]

[email protected]